非均匀性脂肪肝的肝生化指标及代谢相关因素分析

肝脏 ›› 2023, Vol. 28 ›› Issue (11): 1346-1350.

非均匀性脂肪肝的肝生化指标及代谢相关因素分析

师阿盟, 王莹, 马文琦, 刘娜, 周志华, 周琦, 史海涛, 董蕾

710004 陕西西安交通大学第二附属医院医用超声研究室(师阿盟,王莹,刘娜,马文琦,周琦),健康管理部(周志华),消化内科(史海涛,董蕾)

收稿日期:2023-04-28 出版日期:2023-11-30 发布日期:2024-03-03
通讯作者: 董蕾,Email: dong7256@163.com
基金资助:
国家“十三五”重点研发计划(2018YFC1311504)

Analysis of liver function and associated metabolic factors in heterogeneous fatty liver disease

SHI A-meng¹, WANG Ying¹, MA Wen-qi¹, LIU Na¹, ZHOU Zhi-hua², ZHOU Qi¹, SHI Hai-tao³, DONG Lei³

1. Medical Ultrasound Laboratory, the Second Affiliated Hospital of Xi′an Jiaotong University, Shaanxi 710004,China;
2. Department of Health Management the Second Affiliated Hospital of Xi′an Jiaotong University, Shaanxi 710004,China ;
3. Department of Gastroenterology, the Second Affiliated Hospital of Xi′an Jiaotong University, Xi′an, Shaanxi 710004,China

Received:2023-04-28 Online:2023-11-30 Published:2024-03-03
Contact: DONG Lei, Email: dong7256@163.com

摘要/Abstract

摘要： 目的探讨非均匀性脂肪肝的肝生化指标变化及代谢相关因素。方法选取2019年1月—2021年5月西安交通大学第二附属医院诊断的性别及年龄匹配的非均匀性脂肪肝、均匀性脂肪肝及健康人群各180例,比较三组的体质指数(body mass index, BMI)、肝生化指标、血压、血糖、血脂及血尿酸水平;分析非均匀性脂肪肝发生的相关因素。结果 180例非均匀性脂肪肝中,167例为Ⅲ型(弥漫性非均匀浸润型),表现为大部分肝组织呈现密集细小增强的点状回声,小部分区域为低回声,低回声与正常肝实质分界欠清,无占位效应。180例非均匀性脂肪肝中,男性(75.6%)、<45岁(52.8%)、BMI≥ 28 kg/m²(43.3%)占比较高。74.4%的病例ALT正常,25.6%的病例ALT增高,6.1%的病例ALT增高2倍以上。与健康人群相比,非均匀性脂肪肝及均匀性脂肪肝的ALT、AST、ALP、GGT水平均升高,且非均匀性脂肪肝的ALT、AST及GGT较均匀性脂肪肝低。与健康人群相比,非均匀性脂肪肝及均匀性脂肪肝的BMI、血压、血糖、血胆固醇、甘油三酯及尿酸水平均升高,且非均匀性脂肪肝的BMI、血糖及甘油三酯水平较均匀性脂肪肝低。BMI、血糖、血甘油三酯及尿酸是非均匀性脂肪肝发生的独立影响因素,OR(95%CI)分别为1.634(1.362, 1.959)、1.878(1.244, 2.835)、2.844(1.049, 7.710)及1.029(1.019, 1.039)。结论非均匀性脂肪肝以弥漫性非均匀浸润型为主,BMI、血糖、血甘油三酯及尿酸是其发生的独立危险因素。

关键词: 非均匀性脂肪肝, BMI, 血糖, 血甘油三酯, 血尿酸

Abstract: Objective To investigate liver function and associated metabolic related factors in heterogeneous fatty liver disease.Methods In a cohort of 180 individuals each from groups with heterogeneous fatty liver, homogeneous fatty liver, and healthy cohorts matched for gender and age, the body mass index (BMI), liver function, blood pressure, blood glucose, lipid profiles and uric acid levels were compared.Results (1) Of the 180 cases diagnosed with heterogeneous fatty liver, 167 were identified as type Ⅲ (diffuse heterogeneous infiltrative). In these, a pronounced, finely enhanced punctate echogenicity was observed in the majority of the liver tissue, contrasted by hypoechogenicity in certain areas. This hypoechogenicity was ambiguously demarcated from the normal liver parenchyma, with no evident space-occupying effect. (2)In the 180 cases of heterogeneous fatty liver, the majority comprised men (75.6%), those under 45 years of age (52.8%), and individuals with a BMI ≥ 28 kg/m² (43.3%). Furthermore, 74.4% of these cases presented with normal ALT, 25.6% exhibited elevated ALT, and 6.1% display an ALT increase exceeding twice the normal range. (3) When compared to the healthy population, the levels of ALT, AST, ALP and GGT were fournd to be elevated in both heterogeneous fatty liver and homogeneous fatty liver, However, the levels of ALT, AST and GGT were notably lower in the heterogeneous fatty liver group than in the homogeneous fatty liver group. (4) Compared to the healthy population, indices such as BMI, blood pressure, blood glucose, blood cholesterol, triglycerides and uric acid levels were elevated in both heterogeneous and homogeneous fatty liver groups. Yet, the BMI, blood glucose and triglyceride measurements were found to be lower in the heterogeneous fatty liver compared to the homogeneous fatty liver group. (5) The BMI, blood glucose, blood triglycerides and uric acid were identified as independent influencing factors for heterogeneous fatty liver. Their respective OR (95% CI) values were 1.634 (1.362, 1.959), 1.878 (1.244, 2.835), 2.844 (1.049, 7.710), and 1.029 (1.019, 1.039).Conclusion Heterogeneous fatty liver primarily presented as diffuse heterogeneous infiltration, with BMI, blood glucose, blood triglycerides, and uric acid identified as independent risk factors.

Key words: heterogeneous Fatty Liver, BMI, Blood Glucose, Blood Triglycerides, Blood Uric Acid

师阿盟, 王莹, 马文琦, 刘娜, 周志华, 周琦, 史海涛, 董蕾. 非均匀性脂肪肝的肝生化指标及代谢相关因素分析[J]. 肝脏, 2023, 28(11): 1346-1350.

SHI A-meng, WANG Ying, MA Wen-qi, LIU Na, ZHOU Zhi-hua, ZHOU Qi, SHI Hai-tao, DONG Lei. Analysis of liver function and associated metabolic factors in heterogeneous fatty liver disease[J]. Chinese Hepatolgy, 2023, 28(11): 1346-1350.

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